Specific Dietary Protein Sources Are Associated with Cardiometabolic Risk Factors in the Boston Puerto Rican Health Study

Introduction: C-reactive protein (CRP; a marker of inflammation) and the ankle-brachial index (ABI; a marker of peripheral artery disease (PAD)) are considered emerging risk factors for cardiovascular disease (CVD) in addition to traditional cardiometabolic markers. Results on the association of a healthy diet and these emerging risk factors have been inconsistent, and few studies have been conducted on Hispanics/Latinos, who present high prevalence of cardiometabolic risk factors. Hypothesis: We hypothesized that higher diet quality as measured with the Alternate Healthy Eating Index (AHEI; range 0-110: lowest to highest quality) would be associated with lower odds of having high-risk levels of CRP and of ABI, independently from cardiometabolic risk factors. Methods: Baseline data were analyzed from US-Hispanics/Latinos aged 18-74y without previously-diagnosed CVD participating in the population-based Hispanic Community Health Study/Study of Latinos cohort. There were 14,623 participants with complete CRP data, and 7,892 with ABI data (measured only for those aged ≥45y). Food and nutrients components of AHEI were assessed from two 24-hour recalls. High-risk CRP was defined as >3.0 mg/L, and high-risk ABI was defined as <0.90 or >1.40, with further categorization into PAD (<0.90) and arterial stiffness (>1.40). Results: Nearly 35% of Hispanics/Latinos had high-risk CRP levels and 6.3% had high-risk ABI (4.2% had PAD and 2.1% had arterial stiffness). After adjusting for demographic, socioeconomic, and lifestyle factors, as well as cardiometabolic risk factors (diabetes, hypertension, obesity, or dyslipidemia), the odds (95% confidence interval) of having high-risk ABI were 36% (5, 43%) lower for each 10-unit increase in AHEI (p=0.020). The association remained significant for PAD alone, albeit attenuated (p=0.046), but not for arterial stiffness (p=0.210). Each 10-unit increase in AHEI was associated with 21% (10, 31%) lower odds of high-risk CRP(p=0.0003) after similar adjustments. There were no significant interactions between AHEI and sex, background, smoking, or cardiometabolic risk factors for the associations with ABI. The association of AHEI with high-risk CRP was stronger for those with diabetes (0.68 (0.52, 0.89) vs. 0.82 (0.71, 0.94) without diabetes; p-interaction=0.0002) and with obesity (0.70 (0.58, 0.85) vs. 0.86 (0.73, 1.01) without obesity; p-interaction=0.0001). Conclusions: A higher diet quality is associated with lower inflammation and PAD among Hispanics/Latinos, independently from traditional cardiometabolic risk factors. Promoting a healthy overall diet may benefit with further lowering CVD-risk related to emerging factors in a population that already presents high prevalence of cardiometabolic markers.

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Abstract 52: Plasma Metabolomic Signatures of the American Heart Association Diet Score: Findings From the Boston Puerto Rican Health Study

Circulation ◽

10.1161/circ.141.suppl_1.52 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Danielle E Haslam ◽

Jun Li ◽

Liming Liang ◽

Clary Clish ◽

Alice H Lichtenstein ◽

...

Keyword(s):

Risk Factors ◽

Puerto Rican ◽

American Heart Association ◽

Cardiometabolic Risk ◽

American Heart ◽

Metabolic Response ◽

Heart Association ◽

Dietary Guidelines ◽

Health Study ◽

Diet Score

Introduction: Puerto Rican adults living on the US mainland tend to have poor quality diets and adverse cardiometabolic risk. Plasma metabolomic signatures reflect dietary intakes and variability in metabolic response to diet. Hypothesis: A plasma metabolomic signature reflecting adherence to the American Heart Association (AHA) dietary guidelines will be associated with cardiometabolic risk. Methods: We used LC/MS to measure plasma metabolites (>700) among Boston Puerto Rican Health Study participants, aged 45-75 years, without (n=252) and with (n=254) type 2 diabetes (T2D). We calculated a modified version of a previously validated AHA diet score (AHA-DS), which included variety and amounts of fruits/vegetables, whole grains, fish, saturated fat, trans fat, sodium, and added sugars. We used elastic net regression to identify a metabolomic signature that associated with higher adherence to the AHA-DS among those without T2D (training set) and replicated the associations among those with T2D (testing set). A metabolomic score was calculated as the weighted sum of the diet associated metabolites. We used general linear models to determine the cross-sectional associations between the AHA-DS, metabolomic score, and cardiometabolic risk factors. Results: A diet-associated metabolomic signature with 58 metabolites, primarily lipids and amino acids, was identified. This metabolomic score correlated moderately with the AHA-DS among those with and without T2D (r=0.42-0.46, P <5.7x10 -12 ). In all participants (n=506), the metabolomic score, but not the AHA-DS, was significantly associated with higher HDL-C and LDL-C concentrations, and lower waist circumference ( P <0.004; Table 1). No associations were observed for triglyceride concentrations, glycemia measures, or blood pressure. Conclusions: In individuals of Puerto Rican descent, we identified a metabolomic signature that reflected adherence and metabolic response to the AHA dietary guidelines and that associated with cardiometabolic risk factors.

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The impact of type of dietary protein, animal versus vegetable, in modifying cardiometabolic risk factors: A position paper from the International Lipid Expert Panel (ILEP)

Clinical Nutrition ◽

10.1016/j.clnu.2020.05.017 ◽

2021 ◽

Vol 40 (1) ◽

pp. 255-276 ◽

Cited By ~ 2

Author(s):

Fjolla Zhubi-Bakija ◽

Gani Bajraktari ◽

Ibadete Bytyçi ◽

Dimitri P. Mikhailidis ◽

Michael Y. Henein ◽

...

Keyword(s):

Risk Factors ◽

Dietary Protein ◽

Cardiometabolic Risk ◽

Expert Panel ◽

Position Paper ◽

Cardiometabolic Risk Factors ◽

The Impact

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Barriers to Consuming Dietary Protein and Cardiometabolic Risk Factors Among Low-Income and Homeless Adults (P04-089-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.p04-089-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Sam Walker ◽

Kevin Fitzpatrick ◽

Jamie Baum

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Low Income ◽

Dietary Protein ◽

Cardiometabolic Risk ◽

Dietary Habits ◽

Cardiometabolic Risk Factors ◽

Future Research ◽

Homeless Adults ◽

Adequate Food

Abstract Objectives Over 40 million Americans identify as food insecure and lack access to adequate food. The objective of this study was to identify the barriers to consuming dietary protein and to determine how lack of access to dietary protein is associated with cardiometabolic risk factors in food insecure (FI) and homeless adults Methods Participants were recruited during intake at a medical outreach event for homeless and low-income adults living in Northwest Arkansas. A total of 96 adults (62 male and 33 female; 50.3 ±13.3 y) completed the survey. Subjects were asked to verbally respond to questions regarding their current housing and food security status, dietary habits, and general access to medical care. Cardiometabolic risk factors (BMI, glucose, and blood pressure) were also measured. Data was analyzed using Statistical Package for the Social Science v25. Results A total of 74.8% of participants reported some degree of FI. The majority of FI participants reported high- (32.6%) followed by moderate- (31.5%) and low-severity (16.3%); almost half of the participants (44.8%) reported being homeless. Barriers to protein consumption were positively correlated with FI (r = .36; P < .001). Over 70% of participants reported at least one barrier that prevented them from consuming protein. The majority reported that cost was the most important barrier to accessing protein (58%), followed by convenience (25%) and time available to prepare it (22%). In part, due to these and other barriers, more than one-third of respondents reported consuming protein fewer than 5 times per week. There were no associations between FI and cardiometabolic risk factors. Nevertheless, the majority of participants screened (88%) had blood pressure above 120/80 mm and had elevated blood glucose (39.7%) and 76% were either overweight or obese. Conclusions Barriers to consuming dietary protein exist among homeless and low-income adults. Cost and convenience are the two most important barriers among this population subgroup; persons reporting barriers to protein access also reported higher levels of FI. Additionally, food insecurity and homelessness may increase risk for irregular cardiometabolic biomarkers. Future research will focus on how to overcome these barriers and improve markers of cardio metabolic health in adults experiencing FI. Funding Sources American Egg Board/Egg Nutrition Center.

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Dietary protein intake is associated with favorable cardiometabolic risk factors in adults: Tehran Lipid and Glucose Study

Nutrition Research ◽

10.1016/j.nutres.2012.01.003 ◽

2012 ◽

Vol 32 (3) ◽

pp. 169-176 ◽

Cited By ~ 14

Author(s):

Parvin Mirmiran ◽

Majid Hajifaraji ◽

Zahra Bahadoran ◽

Farzaneh Sarvghadi ◽

Fereidoun Azizi

Keyword(s):

Risk Factors ◽

Dietary Protein ◽

Protein Intake ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Dietary Protein Intake

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The Association Between Habitual Avocado Intake and Metabolic Syndrome (P08-035-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p08-035-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Celine Heskey ◽

Keiji Oda ◽

Joan Sabate

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Energy Intake ◽

Cardiometabolic Risk ◽

Hdl Cholesterol ◽

Cardiometabolic Risk Factors ◽

Portion Size ◽

Health Study ◽

Cross Sectional ◽

Funding Sources

Abstract Objectives To assess the relationship between habitual avocado intake, and cardiometabolic risk factors and metabolic syndrome (MetS). We hypothesized that regular avocado intake is associated with a lower occurrence of elevated blood glucose (BG), TG, blood pressure (BP), and waist circumference (WC), and/or decreased HDL-cholesterol (HDL-C). Methods This cross-sectional analysis was done on a random sample (n = ∼850) of subjects from the Adventist Health Study-2 cohort. Diet was assessed using a quantitative FFQ, which included an item for avocado/guacamole intake. Avocado intake (g/day) was calculated: f * s * n where f = the weighted frequency of avocado; s = the weighted portion size of avocado; and n = standard serving size (32 g) of avocado. FFQ data was also used to calculate total energy intake. Medication use, fasting BG, TG, HDL-C, BP, and WC were assessed during clinics. MetS was defined as follows: ≥3 of the diagnostic criteria defined by the Adult Treatment Panel III. Descriptive statistics including differences of means were analyzed. Logistic regression was used to determine the odds of metabolic syndrome for non-consumers (0 g/day; reference) versus consumers (>0 g/day; 51% of subjects) of avocado. Covariates were measured via a questionnaire: age, gender, race, education, energy intake, and dietary patterns. Results The odds for MetS for avocado consumers was non-significantly lower compared to nonconsumers: OR (95% CI) 0.87 (0.58, 1.30). Mean diastolic BP and WC were significantly lower among avocado consumers compared to nonconsumers. Mean HDL-C, TG, BG, and systolic BP did not differ between groups. Conclusions No relationship between habitual avocado intake and MetS has been found. However, there may be an inverse relationship between avocado intake and specific cardiometabolic risk factors: diastolic BP and WC. Funding Sources Hass Avocado Board, NIH, National Cancer Institute.

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